Individual
DR. TIMOTHY ROBERT JESSOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 282-6000
Mailing address
2688 VIA VALDARNO, POCATELLO, ID 83201-5847
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4308
ID
Other
Enumeration date
07/01/2010
Last updated
07/01/2010
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